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Multnomah County Sees First Drop in Homeless Deaths in a Decade but Fentanyl Overdoses Still Surge News By Lucille McNamara On Dec 20, 2025 Opioid overdose rescue kits | Courtesy: Southern Oregon University Of the 372 homeless people who died in Multnomah County last year, 183 overdosed from fentanyl, more than double the 91 deaths linked to the synthetic opioid in 2022. Tidings Data Snapshot Fentanyl linked deaths : people experiencing homelessness 1 2017 : first fentanyl linked death 36 2021 : fentanyl linked deaths 91 2022 : fentanyl linked deaths 251 2023 : fentanyl linked deaths 183 2024 : fentanyl linked deaths Source: Multnomah County Health Department Domicile Unknown 2024 release and report summary Dailytidings.com This is a clear sign of fentanyl’s continued deadly impact on communities, despite programs launched to turn the tide, states the Multnomah County Health Department in its 2024 annual review. Deaths Among the Homeless Population Decreased by 18% The death rate among homeless people was 84 fewer than the 456 deaths in 2023, and is the first decrease since 2013, and the largest reduction at 18% since 2011, when Multnomah County first began analyzing deaths among the homeless population. Multnomah County Chair, Jessica Vega Pederson, described fentanyl deaths as tragic, but is hopeful that the downward trend in the death rate is indicative that the behavioral health services are making an impact on opioid addiction. Her optimism is echoed by Multnomah County health officer, Dr Richard Bruno, who says overdose deaths in 2023 numbered 779, but dropped to 634 in 2024, offering a glimmer of hope for a continued decrease in the future. The Domicile Unknown Report The Multnomah County Health Department has published the Domicile Unknown report since 2012 to determine the characteristics and causes of deaths among homeless individuals in the county. The inclusion of hospital and medical care deaths began after Senate Bill 850 took effect at the beginning of 2022. Place of death Share of deaths Count noted in report Outdoor 40% 149 Hospital (inpatient) 27% 99 Parked car, RV or boat 9% Not listed Hospital (outpatient or ED) 7% Not listed Hotel, corrections, shelter 6% Not listed Home or apartment 5% Not listed Light rail or bus, including platforms 3% Not listed River 2% Not listed Other 2% Not listed This has enabled authorities to pinpoint additional data, such as gender and age groups. In 2024, of the 372 homeless people who died, 301 or 81% were male. The 71 females who died represent 19% of the county’s homeless population. Tidings Data Snapshot Risk gap in 2024 : homelessness vs county overall Drug overdose : 40x higher Homicide : 24x higher Transportation injuries : 23x higher Suicide : 7x higher Any cause : 6x higher Source: Multnomah County Health Department Domicile Unknown 2024 release Dailytidings.com The average age of those who lost their lives while homeless last year is 48, which is 30 years younger than the average lifespan of Multnomah residents. Racial Inequities Continue A further breakdown of the report reveals continued racial inequities among African American and Indian American communities in Multnomah County. African Americans accounted for 12% of deaths among the homeless, compared to 8% of the general population, while Indian Americans accounted for 5% of the death rate and comprise 3% of the general county population. But no amount of optimism can escape the fact that death by drug overdose continues as the dominant factor. Of the 245 deaths from accidental or unintentional injuries in 2024, 87% were from opioid abuse, equating to 214 deaths by drug overdose, of which fentanyl was present in 86% of the cases. View a copy of the 2024 report here. Multnomah County Share Twitter Facebook ReddIt WhatsApp Pinterest Email